Mahajan Nidhi, Agarwal Harshita, Gupta Chhabi Ranu, Sengar Mamta, Khatri Arti, Khan Niyaz
Department of Pathology, Chacha Nehru Bal Chiktsalaya, Delhi, India.
Department of Pediatric Surgery, Chacha Nehru Bal Chiktsalaya, Delhi, India.
J Indian Assoc Pediatr Surg. 2022 May-Jun;27(3):304-308. doi: 10.4103/jiaps.JIAPS_33_21. Epub 2022 May 12.
Colorectal carcinoma (CRC) accounts for <1% of all the neoplasms of children. Unfavorable histology and delayed diagnosis often result in poor outcome. This study aimed to investigate the clinical characteristic and prognosis of pediatric patients with CRC.
A retrospective review of medical records of all patients diagnosed of CRC between 2015 and 2020 was performed. Data regarding gender, age, location, and histopathology were collected.
Seven children (5 males and 2 females) were included in the study. Age ranged between 8.6 and 11.8 years. Abdominal pain was the most common symptom. The duration between onset of symptoms to the diagnosis ranged from 5 days to 8 months. Right-sided tumors were more common than the left side. Histopathological examination showed mucinous adenocarcinoma in four/seven patients and signet cell variant was seen in 2/7. Immunohistochemistry was positive for cytokeratin and beta-catenin, however, all microsatellite instability markers were found negative. Despite surgical treatment and chemotherapy, four of our cases faced mortality and one patient was lost to follow-up.
CRC can present in first decade of life and often misdiagnosed. Pediatric CRC has distinct tumor biology and shares a poor prognosis. Paucity of literature from the Indian subcontinent should urge further clinicopathological trials for establishing etiology and for refining treatment recommendations in these children.
结直肠癌(CRC)在儿童所有肿瘤中占比不到1%。不良的组织学特征和诊断延迟往往导致预后不良。本研究旨在调查儿童CRC患者的临床特征和预后。
对2015年至2020年间所有诊断为CRC的患者的病历进行回顾性研究。收集有关性别、年龄、部位和组织病理学的数据。
本研究纳入了7名儿童(5名男性和2名女性)。年龄在8.6岁至11.8岁之间。腹痛是最常见的症状。从症状出现到诊断的时间间隔为5天至8个月。右侧肿瘤比左侧更常见。组织病理学检查显示,7例患者中有4例为黏液腺癌,7例中有2例可见印戒细胞变体。免疫组化显示细胞角蛋白和β-连环蛋白呈阳性,然而,所有微卫星不稳定标志物均为阴性。尽管进行了手术治疗和化疗,我们的病例中有4例死亡,1例失访。
CRC可出现在生命的第一个十年,且常被误诊。儿童CRC具有独特的肿瘤生物学特性,预后较差。印度次大陆相关文献的匮乏应促使开展进一步的临床病理试验,以确定病因并完善这些儿童的治疗建议。